Final Exam Review

Question 1

List the types of evidence used in Evidence Informed Practice

Answer 1

clinical experience
patient’s presentation
research evidence

Question 2

Clinical experience allows clinicians to develop:

Answer 2

Diagnostic expertise
Clinical motor skills
An understanding of patients needs and preferences
Communication skills

Question 3

Limitations of clinical experience include:

Answer 3

Reverse gullibility
False attribution
Out of sight, out of mind
Clinicians are not statisticians
Fallacy of making hasty conclusions
Rose-colored glasses

Question 4

Advantage of clinical research is _________

Disadvantage of clinical research is _________

Answer 4

usually examines the effectiveness of treatments and diagnostic tests

Not all clinical research is valid, applicable or available.

Question 5

List principle differences between basic science research and clinical research

Answer 5

Basic science provides foundational understanding of organisms and diseases.
Basic science also provides information that is necessary to develop new tests and treatments. It does not usually produce results that can be directly applied to patients.

Clinical research is most often performed in clinical setting, dealing with human subjects

Question 6

Compare the outcomes that are measured in basic science research versus clinical research

Answer 6

Basic science - disease-oriented outcomes e.g. cell count, cell change, biochemical markers

Clinical research - patient-oriented outcomes e.g. quality of life, pain level

Question 7

List types of observational research

Answer 7

Case report
Case series
Case-control studies
cohort studies
cross-sectional studies

Question 8

This type of study identifies an outcome researchers want to know more about (for example Alzheimer’s) and follows people who have developed this outcome. These people are then compared to controls (those without the outcome of interest) to see if there were differences in exposure.

Answer 8

Case control study

Question 9

This type of study is a detailed description of an interesting or unusual case in clinical practice.

Answer 9

Case report

Question 10

A cohort study is ________

Answer 10

Start with a “cohort” of people who do NOT have the outcome of interest and follow them for long periods of time to see if they develop the outcome of interest. Data is collected on levels of exposure to different risks.

Question 11

A cross sectional study is _______

Answer 11

A snapshot of a specific population’s health and behaviors at one point in time.

Question 12

A case series is ________

Answer 12

Observation of a series of persons without a control group

Question 13

Quantitative research uses structured methods to describe ________. It is based on the assumption that ____________

Answer 13

an observation or relationship in numerical terms

reality can and should be measured

Question 14

Most basic science and clinical research is ______ in nature

Answer 14

quantitative

Question 15

Qualitative research aims to understand ___________. It emphasizes understanding what contributes to ___________

Answer 15

human experiences and discover how people interpret the world around them

peoples’ subjective understanding of reality.

Question 16

The evidence pyramid is _______.

What part of the pyramid is most valid? why?

Answer 16

a guide to help clinicians judge the relative validity, or quality, of research studies

Summary research is most valid because it synthesizes ALL of the studies (original research) on a given topic which enhances validity

Question 17

Discuss limitations of summary research

Answer 17

they are never truly up-to-date

results are sometimes difficult to apply to individual patients

Question 18

Usefulness of Research Source = _________

Answer 18

( Relevance x Validity )/ Work

Question 19

What is the 6A Process?

Answer 19

Analyze and Ask to help identify and focus questions

Acquire relevant research (summary sources)

Appraise relevance and validity

Apply evidence using clinical experience and patient presentation

Assess patient’s response

Question 20

Randomized clinical trials generally answer questions about ____________

Answer 20

the effectiveness of treatments

Question 21

List characteristics of RCTs

Answer 21

Performed in controlled settings

Always include a comparison or a control group

Question 22

Advantages of RCTs include _________

Answer 22

They can establish cause and effect relationships with a degree of certainty

A prospective approach

The use of concealed allocation in treatment assignment

The use of blinding

Question 23

Disadvantages of RCTs include _________

Answer 23

In some instances it is impractical, impossible, or unethical to randomly assign patients to an exposure

Lack generalizability

Can’t answer qualitative questions about patient preferences

Can be expensive and time consuming

Question 24

What are methods of reducing bias in RCTs?

Answer 24

blinding
randomization
random allocation

Question 25

Internal validity is an indicator of a study’s ability to _______

External validity indicates ___________

Answer 25

answer the question it intended to answer

how well the study was done (minimize bias?)

Question 26

PICO stands for ___________

Answer 26

Patient/ Problem
Intervention
Control
Outcome

Question 27

List and define types of research bias

Answer 27

Experimenter Bias - observation bias - experimenter’s expectationg affect measurement of participant’s behavior

measurement bias - systematic error favoring particular result

Sampling bias - systematic differences between groups being compared

Question 28

List advantages of using outcome measures in clinical practice

Answer 28

Systematically monitoring how your patients are doing

Providing information that helps you make decisions

Setting goals with patients

Demonstrating to your patients how they are doing and helping to explain your treatment decisions

Demonstrating to others (such as insurance companies and other health care providers) how your patient is doing and helping to justify treatment decisions

Communicating results of an interesting case if you decide to write a case report

Question 29

Assessment of the treatment article/ study. What sections to look at for quick overview of the study?
For determining validity of the study?
For determining why the study was conducted?

Answer 29

abstract

methods

introduction

Question 30

Compare meta-analyses and systematic reviews

Answer 30

Meta-analyses use statistical analysis to combine the results of original studies (quantitative synthesis)

Systematic reviews provide simple summary of original studies (qualitative synthesis)

Question 31

Compare Guidelines and Evidence based textbooks

Answer 31

Guidelines address various aspects of broad topics, like health care conditions. They usually address a range of questions including the prevalence of the condition, the tests and procedures used to diagnose it, and how to prevent and treat it.

Evidence based textbooks are a common source of clinical information. They often provide a well-organized consensus of knowledge in a given field.

Question 32

What are narrative reviews?

Answer 32

Provide simple summary of the studies (qualitative synthesis). Authors have NOT searched for and included ALL available studies on a topic. They do not generally critically appraise the research. Provides authors’ opinions on a topic and so can provide important information that can help you understand key theories and context about health care conditions, treatments, and tests.

Question 33

List STRICTA recommendations

Answer 33

Acupuncture rationale
Needling details
Treatment regimen
Co-interventions
Practitioner background
Control interventions

Question 34

What are the best ways to measure pain in clinical practice?

Answer 34

11-box numerical rating scale
Visual analogue scale
Verbal 0-10 scale

Question 35

What are tests to measure disability?

Answer 35

LBP -The Roland Morris Questionnaire
LBP - The Oswestry Questionnaire
The Neck Disability Index

Question 36

What are tests to measure quality of life?

Answer 36

SF 36
Medical Outcomes 36 Item Short Form Survey
EQ-5D